Have you worked with a scribe?

[EMS5]

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Hey EM residents, I have a quick question....

How many of you have worked with a scribe in the ED?

What qualities and characteristics do you look for in a good scribe?

Muchas thanks.

 

[oxytocin]

The hospitals I am rotating through have scribes. They are well trained and mostly fresh out of college. Most are aiming to apply to medical or PA schools.

Question: How many of other EDs actually have scribes? Is it common?

The extra benefit of scribes is that they drastically seem to decrease the paperwork for the docs. One of the main thing that irked me on my FM rotation is the paperwork. I'm wondering if I'm seeing the actual side of the EP's work load...........since I may have to end up being my own scribe in the future. Or do you think by the time I'm a physician, most hospitals will hire scribes? (I'm currently a 3rd year)

 

[EMCC]

One of the hospitals I work at uses scribes. Mostly, they are either pre-med/pre-PA students or taking courses in some science majors (not really sure).

For the most part, I think the scribes work out really well. They do most of my scut for me, which really does free me up for other tasks. For example:
- if I print out discharge instructions, they usually pick it up from the printer (along with prescriptions) and put them on the chart for me.
- they will call consultants for me, or at least find out who is covering for them that day
- they get me food! huge help when I forget, in the flow of the ED, to eat
- they write up the H+P while I am doing it--freeing me up to maintain eye contact the entire time, and actually look like I am listening to the patient (even if I really am not)

I don't remember which journal cited it, but there was an article that came out within the past 6 months or so that detailed how scribes increase ED provider productivity and increase RVUs. Interesting and not surprising to say the least.

The concept of a scribe has been around for a while. Despite many positives, there are a few negatives (e.g. cost), so don't hold your breath waiting for every ED in the country to have scribes within the next ten years. I think even 10% of EDs having scribes would be a remarkable event...

 

[digitlnoize]

One of the hospitals I work at uses scribes. Mostly, they are either pre-med/pre-PA students or taking courses in some science majors (not really sure).

For the most part, I think the scribes work out really well. They do most of my scut for me, which really does free me up for other tasks. For example:
- if I print out discharge instructions, they usually pick it up from the printer (along with prescriptions) and put them on the chart for me.
- they will call consultants for me, or at least find out who is covering for them that day
- they get me food! huge help when I forget, in the flow of the ED, to eat
- they write up the H+P while I am doing it--freeing me up to maintain eye contact the entire time, and actually look like I am listening to the patient (even if I really am not)

I don't remember which journal cited it, but there was an article that came out within the past 6 months or so that detailed how scribes increase ED provider productivity and increase RVUs. Interesting and not surprising to say the least.

The concept of a scribe has been around for a while. Despite many positives, there are a few negatives (e.g. cost), so don't hold your breath waiting for every ED in the country to have scribes within the next ten years. I think even 10% of EDs having scribes would be a remarkable event...

I'm now a 2nd year DO student who worked as a scribe for a couple of years in undergrad. I loved it, and found it great preparation for med school. Thanks to that experience, I feel like my clinical experience is better than many of my classmates...except the other scribes, or long-time EMT's/nurses/etc...

I do think we improved productivity. I also think that ED's could get away with paying much less than they do. We were only paid $8-10/hr, but I know that I would have done it for less, because good pre-med experiences that will look THAT good on your app are hard to come by.

That being said, I am sometimes amazed by how much I didn't know, and how much may have gone over my head at the time...If you do have a scribe, I highly recommend teaching them everything you can...

 

[EMCC]

Yeah, I usually try to treat the scribes as a MS1, and teach them ONE thing about each patient encounter. Usually it is stuff like basic anatomy (how much compartments does the mediastinum have, or if too complicated, what lies within the mediastinum). I like it, because it keeps the basic sciences fresh, and I hope they like it as a primer to what they will learn once they get to med school...

The only time having a scribe gets almost ornerous (is that a word??), is when pure chaos has set in the department and I don't know what I am doing. let alone keep tabs on a newbie...

 

[digitlnoize]

Yeah, I usually try to treat the scribes as a MS1, and teach them ONE thing about each patient encounter. Usually it is stuff like basic anatomy (how much compartments does the mediastinum have, or if too complicated, what lies within the mediastinum). I like it, because it keeps the basic sciences fresh, and I hope they like it as a primer to what they will learn once they get to med school...

The only time having a scribe gets almost ornerous (is that a word??), is when pure chaos has set in the department and I don't know what I am doing. let alone keep tabs on a newbie...

When things got that crazy, we would usually kinda become organizers. We didn't often do traumas, for example, because...well, there's not so much we can do there...so, if the doc got his hands full with a couple of crashing cases, we'd go back to monitoring everything else.

Following labs (which they did teach us about fairly well), figuring out which patients to see next. Often the doc would come back and have no idea what he was doing, which is when we would tell them:

"You're going to see Mr. Kidney Failure in Room 2, then Mrs. Migraine in Room 3, we're waiting on a call from Dr. Heart for the MI in Room 4, and your wife called, but I told her things were crazy and you'd call her back later. Oh, and here's a snack I grabbed from the Doctor's Lounge."

Fun times.

 

[Jeff698]

"You're going to see Mr. Kidney Failure in Room 2, then Mrs. Migraine in Room 3, we're waiting on a call from Dr. Heart for the MI in Room 4, and your wife called, but I told her things were crazy and you'd call her back later. Oh, and here's a snack I grabbed from the Doctor's Lounge."

This, plus charting seems to be well worth it to me.

Take care,
Jeff